| NPI | 1053541524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: FL AP 3267) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: FL MA53259) |
| Enumeration Date | 2009-07-19 |
| Last Update Date | 2013-11-08 |